Migraines and tension headaches can be debilitating. They often come out of nowhere and hit hard, preventing you from carrying on with normal activities. These headaches affect more Australians than you would expect, with an estimated 4.9 million people experiencing migraines each year. Tension headaches are often less severe, though they still impact productivity, concentration and quality of life. Physiotherapy is a valuable way to manage migraines and tension headaches, address imbalances, improve posture and reduce muscle tension. We explore how physiotherapy interventions can offer relief, reduce the frequency and intensity of headaches and improve overall wellbeing.

Migraines and tension headaches are often grouped under the umbrella of "headaches". However, they are two distinct conditions with different causes, symptoms and treatment approaches. Understanding the differences between the two is essential for effective management.

Migraines are characterised by severe throbbing pain or a pulsing sensation, often on one side of the head. They are frequently accompanied by nausea, sensitivity to light and sound, and visual disturbances known as aura. Migraines can last anywhere from a few hours to days, and their frequency varies from person to person. Triggers may include stress, hormonal changes, certain foods and environmental factors.

In contrast, tension headaches typically cause mild to moderate pain that affects both sides of the head, often described as a tight band around the forehead or temples. Unlike migraines, tension headaches are less likely to involve nausea or visual disruptions. They are usually linked to muscle tension, poor posture and prolonged stress or screen time periods.

According to the Migraine Foundation Australia, migraines are the leading cause of disability for Australians under 50. With our sedentary lifestyles and increased digital device usage, the number of individuals experiencing tension headaches is also on the rise. Recognising the underlying triggers and patterns is the first step in managing these conditions effectively. This is where physiotherapy plays a pivotal role.

Physiotherapy offers a non-invasive approach to managing migraines and tension headaches that focuses on identifying the underlying causes and developing tailored treatment plans to reduce headache frequency, intensity and duration.

There are many different causes of tension headaches and migraines.

Tightness in the neck, shoulders and upper back can lead to tension headaches and even migraines. Physiotherapists use massage and trigger point therapy to relieve muscle tightness and improve blood flow. Dry needling also targets trigger points within tight muscles, while acupuncture focuses on energy flow and relieving pain. Both techniques make use of the body’s natural painkillers to relieve the effects of headaches and migraines.

Poor posture, especially for those spending long hours at a desk, can lead to strain in the muscles. A physiotherapist can provide exercises to strengthen the muscles that support the head and neck, reducing the likelihood of tension headaches. They will also offer ergonomic advice for workplace and home settings and stretching routines to implement daily to help with the effects of prolonged sitting.

Stress is a big trigger for both migraines and tension headaches. Physiotherapists help with breathing exercises and relaxation techniques to manage stress and prevent headaches. Regular exercise also plays an important role in preventing headaches by improving posture, reducing stress and strengthening the muscles that support the head and neck. These might include chin tucks and neck retraction, shoulder blade retraction and neck and upper back stretches.

Educating patients on headache triggers, ergonomics and lifestyle changes is a cornerstone of physiotherapy. By understanding how daily habits contribute to their condition, patients can take proactive steps to reduce the impact of headaches.
Knowing when to seek physiotherapy for migraines and tension headaches can help prevent chronic symptoms and improve overall quality of life. Here’s when to seek physiotherapy:

• Persistent Headaches: Headaches lasting longer than 48 hours or occurring frequently over a month may benefit from physiotherapy intervention.
• Chronic Pain Management: If you’ve tried over-the-counter medications or other treatments without success, physiotherapy offers a drug-free, long-term solution.
• Post-Injury Headaches: Headaches following whiplash, sports injuries, or trauma to the neck should be assessed by a physiotherapist to prevent chronic pain.
• Headaches Associated with Stress: Physiotherapy techniques, such as relaxation exercises and muscle release, can help manage stress-induced headaches.

While physiotherapy can be highly effective, certain symptoms may require immediate medical attention:

• Sudden onset of severe headaches (thunderclap headaches).
• Headaches that come with confusion, slurred speech, or weakness.
• Headaches following head trauma.
• Headaches with visual disturbances or neurological symptoms.

Physiotherapists often collaborate with GPs or neurologists to ensure comprehensive care.

Physiotherapy is an effective and non-invasive approach to managing migraines and tension headaches, offering relief by addressing the underlying issues. Through techniques such as manual therapy, postural correction and targeted exercises, physiotherapists help reduce headache frequency and intensity, providing long-term solutions. For those struggling with persistent headaches, taking the first step toward booking a physiotherapy consultation could open the door to a better quality of life.